BMJ  2003;327:502 (30 August), doi:10.1136/bmj.327.7413.502-b

Letter

Passive smoking

Doubts about effectiveness of age adjustment

The first 150 words of the full text of this article appear below.

Editor—According to Enstrom and Kabat's figures the greater had been a man's cigarette consumption in 1959 the less likely, it seems, was the death of his wife from coronary heart disease.¹ However, an age bias existed in those women at the outset. In 1959 their mean age decreased with spousal smoking, such that the wives of men smoking 40 a day were a mean four years younger than wives of men smoking one to 19 a day, probably as a consequence of early death of smoking husbands of similarly aged wives (table 3 on bmj.com).

During the study period mortality from coronary heart disease fell by about 15% every four years.² The "passive" smokers were therefore predominantly from later cohorts for whom, age for age, mortality from coronary heart disease had fallen significantly in comparison to controls. The same argument applies to never smoking husbands of smoking women who . . . [Full text of this article]

Northumberland and Tyne and Wear Strategic Health Authority, Newcastle General Hospital, Newcastle upon Tyne NE4 6BE eugene.milne@ntwha.nhs.uk

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